Narrative review of male urethral sling for post-prostatectomy stress incontinence: sling type, patient selection, and clinical applications

Bole, Raevti; Hebert, Kevin; Gottlich, Harrison C; Bearrick, Elizabeth; Köhler, Tobias; Viers, Boyd R.

doi:10.21037/tau-20-1459

Cited by 13 publications

(17 citation statements)

References 92 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Traditionally, an AUS has been considered the "gold standard" for SUI and is a valid treatment for all degrees of symptoms. MS have typically been reserved for men with mild or moderate incontinence (13). Both AUS and MS are safe, with AUS having a slightly higher rate of postoperative complications (5.1% vs. 2.8%) in an analysis of ACS-NSQIP (American College of Surgeons National Surgical Quality Improvement Program) data (14), which evaluated 608 patients undergoing AUS and 597 patients receiving a MS.…”

Section: Bulking Agentsmentioning

confidence: 99%

“…MS work by compressing and repositioning the bulbar urethra (13). When on appropriate tension, the sling will relocate the urethral bulb proximally into the pelvis and will also provide support to the dorsal distal portion of the membranous urethra (15).…”

Section: Fixed Msmentioning

confidence: 99%

“…This was followed by a series of 67 patients (17) and shortly thereafter developed into the AdVance Male Sling (Boston Scientific, Marlborough, MA USA) (18). The secondgeneration AdVance XP entered the market in 2010 (19) with design modifications including a new anchoring mechanism to prevent migration, a liner, and longer mesh arms for easier use in obese patients (13). The interested reader can find links to the companies' websites in Appendix 1 for photos of the devices.…”

Section: Fixed Msmentioning

confidence: 99%

See 2 more Smart Citations

A narrative review on surgical treatment options for male stress urinary incontinence

Prebay¹,

Foss²,

Wang³

et al. 2023

Transl Androl Urol

View full text Add to dashboard Cite

Background and Objective: Stress urinary incontinence (SUI) can occur due to a variety of etiologies.For male patients specifically, SUI is typically thought of as iatrogenic secondary to intrinsic sphincter deficiency occurring after prostate surgery. Given the noted negative impact that SUI can have on a man's quality of life, multiple treatment options have been developed to improve symptoms. However, there is no "One-Size-Fits-All" approach to management of male SUI. In this narrative review, we sought to highlight some of the various procedures and devices available to treat men with bothersome SUI.Methods: This narrative review gathered primary resources through Medline search, and secondary resources by cross-referencing citations used in articles of interest. We started our investigation by searching for previous systematic reviews on male SUI and treatments for male SUI. Furthermore, we reviewed societal guidelines, such as the American Urological Association and Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction guidelines and the recently published European Urological Association guidelines. Our review focused on English-language full-length manuscripts when available.

show abstract

Section: Bulking Agentsmentioning

confidence: 99%

Section: Fixed Msmentioning

confidence: 99%

Section: Fixed Msmentioning

confidence: 99%

See 1 more Smart Citation

A narrative review on surgical treatment options for male stress urinary incontinence

Prebay¹,

Foss²,

Wang³

et al. 2023

Transl Androl Urol

View full text Add to dashboard Cite

show abstract

“…A recent systematic review and meta‐analysis found that AUS is better than slings for moderate male SUI 69 . Multiple sling materials and devices are available with published data showing reasonable effective and safety outcomes, 1,70 although many synthetic male slings are not registered or widely available in the AP region 71 . At present, there is no strong evidence to suggest that one type of male sling is better than another sling 72–74 .…”

Section: Main Recommendationsmentioning

confidence: 99%

The Asia‐Pacific AMS800 artificial urinary sphincter consensus statement

et al. 2022

View full text Add to dashboard Cite

This Asia-Pacific (AP) AMS 800 TM artificial urinary sphincter (AUS) consensus statement aims to provide a set of practical recommendations to assist surgeons with the AMS 800 device surgery. The AP consensus committee consisted of key opinion leaders with extensive experience with AMS 800 surgery across several AP countries. The panel reviewed and discussed relevant findings with emphasis on locoregional and specific clinical challenges relevant to the AP region. Recommendations were made in key areas namely (1) patient selection and informed consent process; (2) preoperative assessment; (3) dealing with co-existing urological disorders; (4) surgical principles and intraoperative troubleshooting; (5) postoperative care; (6) special populations; and (7) cost analysis and comparative review. The AMS 800 device should be offered to males with moderate to severe stress urinary incontinence (SUI). Full informed consent should be undertaken, and emphasis is placed on surgical contraindications and high-risk candidates. The presence of a surgical mentor or referral to experts is recommended in complex AUS candidates. Preoperative cystoscopy with or without multichannel urodynamic study is necessary and patients with pre-existing urological disorders should be treated adequately and clinically stable before surgery. Adherence to strict patient selection and safe surgical principles are critical to ensure excellent clinical outcomes and minimize complications. Given that InhibiZone-coated device is not available in many AP countries, the use of prophylactic antibiotics pre-and post-operatively are recommended. The AMS 800 device should be prepared according to the manufacturer's guidelines and remains a cost-effective treatment for male SUI. The AMS 800 device remains the surgical benchmark for male SUI but is associated with certain mechanical limitations and a unique set of complications.

show abstract

“…8,9 Several types of slings are currently available that differ in materials, design, size, mechanism of action and technique of implantation. 10 Advantages of male slings are the nonmechanical nature, immediate post-operative results, lower cost and lower rate of severe complications than AUS. 8 However, failure rates after slings placement range between 15% and 45% while current knowledge of predictors of sling efficacy remains limited.…”

Section: Introductionmentioning

confidence: 99%

Protocol for a systematic review and meta-analysis on preoperative risk factors for failure after fixed sling implantation for post-prostatectomy stress urinary incontinence

Sacco

Marino²,

Gavi³

et al. 2023

F1000Res

View full text Add to dashboard Cite

Background: Post-prostatectomy urinary incontinence (PPI) is a bothersome complication affecting patients undergoing prostate surgery that in up 10% of cases will require an invasive treatment with fixed slings or artificial urinary sphincters (AUS). Although fixed slings have several advantages over AUS, failure rates after slings range between 15% and 45% while current knowledge of predictors of sling efficacy remains limited. By systematically combining and summarizing all relevant literature, the present review and meta-analysis aim to address this research need assessing the association between preoperative risk factors and sling failure. Methods: Studies pertaining to fixed synthetic male perineal slings as treatment for adult male suffering from PPI, will be included. A systematic search will be conducted in PubMED, Scopus, Web of Science and Cochrane databases, and in the reference lists of retrieved articles. Independent reviewers will conduct study selection and data extraction. Outcomes will include failure to achieve the continence cure and overall success (cure plus improvement), measured as per included studies. Exposures will include any preoperative variables evaluated for association with sling failure. The QUIPS tool will be used for study quality assessment and a random-effects DerSimonian-Laird model, with Hartung-Knapp adjustment, will be used to pool adjusted and unadjusted odds ratios separately. Sensitivity analysis will be performed using the leave-one-out methodology and subgroup meta-analyses based on pre-specified studies’ characteristics will be conducted to explain the heterogeneity. Certainty of evidence will be assessed according to GRADE methodology and review reporting will comply with the PRISMA-P statement. Discussion: By summarising all relevant literature in the field, our results will help to incorporate available evidence into clinical practice assisting healthcare professionals managing PPI patients in treatment decision-making. The present review will also provide researchers with the necessary, evidence-based groundwork to perform future high-quality prognostic studies in the field. Registration: CRD42022307160.

show abstract

Narrative review of male urethral sling for post-prostatectomy stress incontinence: sling type, patient selection, and clinical applications

Cited by 13 publications

References 92 publications

A narrative review on surgical treatment options for male stress urinary incontinence

A narrative review on surgical treatment options for male stress urinary incontinence

The Asia‐Pacific AMS800 artificial urinary sphincter consensus statement

Protocol for a systematic review and meta-analysis on preoperative risk factors for failure after fixed sling implantation for post-prostatectomy stress urinary incontinence

Contact Info

Product

Resources

About